Hatzell v. Health and Hosp. Corp. of Marion Cty. — Nov. 2016 (Summary)

EMTALA

Hatzell v. Health and Hosp. Corp. of Marion Cty.
No. 1:15-cv-00964-LJM-TAB (S.D. Ind. Nov. 18, 2016)

The United States District Court for the Southern District of Indiana granted a hospital’s motion for summary judgment against a patient’s claim brought under the Emergency Medical Treatment and Active Labor Act (“EMTALA”).

An adult, mentally handicapped patient was taken to a hospital’s emergency room with complaints of lethargy, constipation, stomach pain, and an inability to urinate.  The patient was examined, an x-ray of her abdomen was taken to assess constipation, and the resident physician ordered a urinalysis.  The patient was unable to urinate for the urinalysis, and her x-rays revealed that she was moderately constipated.  The resident physician told the patient’s mother that they could not find anything physically wrong with the patient, and he prescribed a laxative.  Though the resident physician knew a urinalysis would help determine whether a patient had a urinary tract infection or impaired kidney function, the urinalysis was not performed.

The next day, the patient was taken to the same hospital’s emergency room for a second time because she fell down the stairs and was unresponsive.  Upon arrival, the patient underwent several screening procedures to assess her injuries from the fall, including CT scans and x-rays.  Upon completion of the screenings, the resident physician available told the patient’s mother that the only thing they found wrong with the patient was a broken nose.  The patient’s mother told the physician that the patient still had not urinated and that her abdomen was noticeably distended, but the physician reiterated that they did not find anything physically wrong with the patient beyond her broken nose.  The physician did not order any testing for a urinary tract infection, nor did the physician ask for the patient’s comprehensive medical history as is customary when a patient with limited ability to communicate due to mental disability arrives at the emergency room.

Five days later, the patient still had not urinated and she became nonresponsive.  Her mother took her to a different hospital’s emergency department.  Upon arrival, lab tests and a urinalysis were immediately ordered and performed.  The patient’s health records indicated that she had previously suffered from urinary disorders, and her lab results were extremely and dangerously abnormal.  The patient was then diagnosed with acute renal failure and a urinary tract infection.  The patient suffered permanent physical and mental disabilities.

The patient’s estate filed an action against the first hospital, alleging that it violated EMTALA by failing to properly screen the patient for a urinary disorder.  The district court disagreed with the estate, and found their claim to be in line with a medical malpractice action, not an EMTALA violation.  On both occasions, the patient was screened and assessed in the emergency room based on the symptoms she presented.  EMTALA does not require a correct diagnosis, it only requires a proper screening.  A proper screening is based on whether the patient received the same type of screening that other patients presenting with the same symptoms would have received.  There is no evidence that the patient was treated differently than another patient in a similar circumstance.  Though the resident physicians could be alleged to have been negligent in not performing a urinalysis on both occasions, such negligence would not constitute a violation of EMTALA.